Active NPI
Irene Shane Klotz, LMSW CPT
- Social Worker
- Bronx, NY
National Provider Identifier
1295171817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 049540-1
- Practice address
- 3265 Johnson Ave
Suite 105
Bronx, NY 10463-3539 - Phone
- (917) 796-4456
- NPI assigned
- May 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 049540-1 | NY | |
| Behavior Analyst | 103K00000X | 049540-1 | NY | |
| Social Worker | 104100000X | 049540-1 | NY | Primary |
| Case Manager/Care Coordinator | 171M00000X | 049540-1 | NY | |
| Community Health Worker | 172V00000X | 049540-1 | NY | |
| Specialist | 174400000X | 049540-1 | NY | |
| Health Educator | 174H00000X | 049540-1 | NY | |
| General Practice Physician | 208D00000X | 049540-1 | NY | |
| Phlebotomy Technician | 246RP1900X | 049540-1 | NY |
Addresses
Primary practice location
3265 Johnson Ave
Suite 105
Bronx, NY 10463-3539
Mailing address
3265 Johnson Ave
Suite 105
Bronx, NY 10463-3539
Phone (917) 796-4456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049540-1 | NY | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1295171817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3265 JOHNSON AVE",
"address_2": "SUITE 105",
"city": "BRONX",
"state": "NY",
"postal_code": "104633539",
"telephone_number": "917-796-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3265 JOHNSON AVE",
"address_2": "SUITE 105",
"city": "BRONX",
"state": "NY",
"postal_code": "104633539",
"telephone_number": "917-796-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOTZ",
"first_name": "IRENE",
"middle_name": "SHANE",
"name_prefix": "Ms.",
"credential": "LMSW CPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "049540-1",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "049540-1",
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "NY",
"license": "049540-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.